What could we learn from federally funded gun research?

By Susan Scutti, CNN

Updated 1:50 PM ET, Thu October 12, 2017

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Parents wait for news after a shooting at Marjory Stoneman Douglas High School in Parkland, Florida, on Wednesday, February 14. At least 17 people were killed at the school, Broward County Sheriff Scott Israel said. The suspect, 19-year-old former student Nikolas Cruz, is in custody, the sheriff said. The sheriff said he was expelled for unspecified disciplinary reasons.

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In December 2015, two shooters killed 14 people and injured 21 at the Inland Regional Center in San Bernardino, California, where employees with the county health department were attending a holiday event. The shooters, Syed Rizwan Farook and his wife Tashfeen Malik, were later killed in a shootout with authorities. The pair were found to be radicalized extremists who planned the shootings as a terror attack, investigators said.

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Virginia Tech student Seung-Hui Cho went on a shooting spree on the school's campus in April 2007. Cho killed two people at the West Ambler Johnston dormitory and, after chaining the doors closed, killed another 30 at Norris Hall, home to the Engineering Science and Mechanics Department. He wounded an additional 17 people before killing himself.

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Mark Barton walked into two Atlanta trading firms and fired shots in July 1999, leaving nine dead and 13 wounded, police said. Hours later, police found Barton at a gas station in Acworth, Georgia, where he pulled a gun and killed himself. The day before, Barton had bludgeoned his wife and his two children in their Stockbridge, Georgia, apartment, police said.

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Story highlights

The Las Vegas shooting sparked more discussions about funding gun violence research

The American Medical Association and other groups have called for CDC-funded research on gun violence

(CNN)The naming of the victims has become a familiar national ritual. In the wake of violence, we learn the names and lives of each unfortunate soul who happened to be in the cross hairs of a killer.

Eulogies also speak to another need, some say: more federally funded research of gun violence.

Since the mid-1990s, the federal government has blocked or restricted funding for scientific research into gun violence. After mass shootings, including the one in Las Vegas, some researchers argue that it's a dire, immediate need, and that gun violence is a public health issue. They say studies exploring the topic might lead to public policies that reduce the number of deaths.

It's similar to the study of automotive deaths and risks during the 1950s and 1960s, said Dr. James F. Peggs, professor emeritus at University of Michigan Medical School. That research led to improvements in car safety.

The same would be true for ways to increase gun safety, said Peggs, who is a board member for Physicians for the Prevention of Gun Violence.

"The reluctance to do research makes no sense," said Dr. Alan Leshner, CEO emeritus of the American Association for the Advancement of Science, who added that "there isn't enough of a call for more research."

"It's one of the few public health problems facing the country about which we have basically no scientific base of information to guide us how to deal with it," said Leshner.

Some public health researchers say the lack of current scientific research on gun violence stems from the conclusions scientists reached about gun ownership decades ago.

In 1993, the New England Journal of Medicine published a study that had been funded by the US Centers for Disease Control and Prevention.

The study examined a total of 1,860 homicides that occurred between 1987 and 1992 in two counties in Tennessee and Washington and between 1990 and 1992 in one county located in Ohio. Of these, 444 (or nearly 24%) fatalities took place in the home of the victim.

Dr. Arthur L. Kellermann, the lead author of the 1993 study and now dean of the F. Edward Hébert School of Medicine, estimated that keeping a gun in the home was associated with a 2.7-fold higher risk of homicide when compared with similar households without guns.

"Virtually all of this risk involved homicide by a family member or intimate acquaintance," wrote Kellermann and his co-authors.

This study, then, presented a challenge to the belief that possession of a gun enables self-defense and so increases personal safety in the home.

The National Rifle Association responded to the study, according to the APA, by campaigning for the elimination of the CDC's National Center for Injury Prevention, which had funded the study. In response to pressure from gun lobbyists, members of Congress then restricted federal funds for gun violence prevention research.

In 1996, Congress attached the Dickey amendment to its appropriation bill for fiscal year 1997.

Named for its author and former US House Rep. Jay Dickey, the amendment specified that "none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control."

While this language does not explicitly ban research on gun violence, the CDC's previous investment of $2.6 million into firearm injury research was redistributed to study traumatic brain injury prevention.

While the CDC commonly shifts budget priorities, some scientists saw the Dickey amendment as a way to "silence" the science of gun research. Private support for studies also dried up, Kellermann said in a commentary published in 2013.

Others in the scientific community agree.

"The Dickey amendment -- that caused a virtual blockade on any federal funding, any NIH funding having anything to do with gun violence or research on gun violence," said Peggs. He added that "for decades now" any institution or individual who wanted to obtain funding from the federal government -- a primary source of academic funding -- would be immediately "scratched off the list" if their application made "any mention whatsoever of firearms."

Daniel Webster, director of the Johns Hopkins Center for Gun Policy and Research, said that "there's been an oversimplification of the lack of funding in this area."

There is government funding, he said, but mostly it has gone to studies of policing strategies and behavior change but not the most controversial policy questions, including right to carry laws.

The federal government, then, does not invest in research about the impact of gun laws or "other kinds of sensitive questions that are fundamental to the gun industry," said Webster. Instead, those studies are done on a shoestring budget, he said.

"There's a lot of ways in which gun violence impacts our society and we've invested a pittance," Webster said.

Research resumed by executive order

Change followed the day in December 2012 when 20 children and several adults were killed at Sandy Hook Elementary school in Newtown, Connecticut.

On January 16, 2013, then-President Barack Obama issued an executive order directing federal agencies to study gun violence. The National Academy of Sciences Engineering and Medicine convened a special committee, which was chaired by Leshner, to perform a consensus study. This request came from the CDC in response to the executive order.

"We laid out a bunch of questions -- a list of researchable questions -- scientifically testable questions that one would ask in order to get to a better understanding of both the nature of the problem and what to do about it," said Leshner.

The report's proposed questions and areas of research are organized as: characteristics of firearm violence, including the types and numbers of firearms; risk and protective factors associated with firearm-related violence; firearm violence prevention and other interventions, including unauthorized gun possession; impact of gun safety technology; and a review of the impact of video games and other media.

"Nothing," said Leshner. "Because of Obama's executive order, we thought the CDC would mount the research agenda, but people had left CDC who had requested the study and the agency had other priorities by the time the study came out."

While some assume gun advocates outright squash research, that is not necessarily the case, said Leshner.

"Every group on every side of the issue" had testified to his committee, said Leshner, and "every single group said it would be a good idea to have a research base."

Gun Owners of America Legislative Counsel Michael Hammond said "we have no problem with scientific research."

"We would benefit from solid scientific research but we don't expect the CDC would give that to us," said Hammond, noting his organization exists for the purpose of promoting the Second Amendment and the constitutional rights of its "1.5 million law-abiding" members and followers.

Hammond said the science produced by CDC would only serve "the purpose of promoting a political agenda" that does not support the right to bear arms.

Meanwhile, some researchers claim their goal is not to disarm citizens, but to save lives.

What researchers want to know

"The public health implications are obvious," he said. People die or get injured from guns every day. "The question is -- without violating their Second Amendment rights -- what can be done to minimize the unintended negative consequences of the ability of people to own firearms?" he said. This, he said, is the reason research is necessary.

"It's probably the public health issue about which we know the least," said Leshner. "We don't know what interventions work to minimize firearm related violence and we don't know much even about the prevalence, how many guns there are out there."

Webster agrees.

"At the top of my list is more careful study of the underground gun market," he said.

"Guns don't just drop from the sky. They start somewhere in commerce and if the laws and regulations and enforcement are weak, it's easy for the guns to be diverted from the legal market to the underground economy," he said. "But we really don't have much data or understanding on how all that works."

There is also a lack of research on background check laws and other policies designed to prevent dangerous people from possessing guns, noted Webster.

"Everyday in cities around the country, police are recovering guns from criminal suspects who are not the legal purchasers, but only in the rarest of circumstances do they bother to find out how that person got the gun," he said.

With suicides by gun about twice as common as homicides by gun in 2015, according to the CDC, "there's a lot of interest among public health researchers" to study strategies to limit access to guns among people who might self-harm, said Webster.

Some critically important lessons have already been learned -- for example, disarming people with restraining orders for domestic violence reduces homicide -- still, gun violence is a large, complex issue with many dimensions, said Webster.

"You have mass shootings, you have domestic homicide, you have urban gun violence, and you have suicides," he said, and then added,"not to mention unintentional shootings."

Peggs said gun violence "is as massive in scale a public health risk as smoking, automobile safety, and obesity," yet, there's no question that research is just "scratching the surface." The Physicians for the Prevention of Gun Violence emphasizes taking "small steps."

Small steps include talking to patients.

"It should be a standard issue we discuss with our patients, much as we do wearing seat belts and bike helmets -- those are all standard questions we ask of our patients now," said Peggs.

Helping physicians help patients

Physicians for the Prevention of Gun Violence has also been giving talks to groups of doctors around the state of Michigan for years "just to alert them to the issue that the risk of gun violence is substantial," he said.

In these group sessions, doctors acknowledge their discomfort in talking to patients.

"What if they say, 'Yes, I have a gun in the home,'" said Peggs. "How are we supposed to respond?" What if the patient becomes "very defensive and angry and says it's got nothing to do with their health?" he said.

Research could lead to pamphlets about safe gun storage becoming available in the waiting rooms of health providers.

"Can we make guns as smart as our cell phones? I can't just hand mine to a friend unless they know the code to use it," said Peggs.

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Small steps also include physicians trying to prevent violence by assisting in the removal of guns from the homes of depressed patients who might be suicidal, he said.

Peggs emphasized that, just as researchers from yesteryear did not ban cars from the road, he is not seeking to banish guns from homes. Research simply led to cars being made safer through new features and laws.